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目的探讨血清前列腺特异性抗原(PSA)、碱性磷酸酶(ALP)、骨钙素(OC)水平检测在前列腺癌患者术后骨转移临床诊断中的应用价值。方法选取2013年12月至2016年7月本院收治的66例前列腺癌患者,将其中34例术后发生骨转移的患者设为研究组,其余32例未发生骨转移的患者设为对照组;根据骨转移级别将研究组患者分为3个亚组(Ι级组11例,Ⅱ级组13例,Ⅲ级组10例)。抽取两组空腹静脉血,测定血清PSA、OC、ALP水平。统计分析两组血清OC、ALP、PSA水平并研究不同骨转移级别患者血清OC、ALP、PSA水平的差异,探索血清OC、ALP、PSA单独诊断与联合诊断前列腺癌术后骨转移的价值。结果研究组血清OC、ALP、PSA水平高于对照组,差异均有统计学意义(均P<0.05);Ⅱ级组血清OC、ALP、PSA水平高于Ι级组,Ⅲ级组血清OC、ALP、PSA水平高于Ⅱ级组,差异均有统计学意义(均P<0.05);血清OC、ALP、PSA联合诊断的敏感度(94.12%)、特异度(90.63%)、准确度(92.42%)高于OC(73.53%、59.38%、66.67%)、ALP(67.65%、59.38%、63.64%)、PSA(70.59%、56.25%、63.64%)单项检测,差异均有统计学意义(均P<0.05)。结论联合检测血清OC、ALP、PSA水平可有效提高前列腺癌患者术后骨转移检测的特异度、准确度及敏感度,同时对评估骨转移严重程度具有一定参考价值。
Objective To investigate the value of serum PSA, ALP and OC in the clinical diagnosis of postoperative patients with prostate cancer. Methods Sixty-six patients with prostate cancer admitted from December 2013 to July 2016 in our hospital were enrolled. 34 patients with bone metastasis were selected as the study group, and the remaining 32 patients without bone metastasis were selected as the control group According to the grade of bone metastasis, the study group was divided into three subgroups (11 in the Ι-level group, 13 in the ¢ ò-level group and 10 in the ¢ ö-level group). Two groups of fasting venous blood samples were taken for determination of serum PSA, OC and ALP levels. The levels of serum OC, ALP and PSA in two groups were statistically analyzed. The levels of serum OC, ALP and PSA in patients with different bone metastases were also studied. The value of serum OC, ALP and PSA alone and combined diagnosis of postoperative bone metastasis in prostate cancer was explored. Results Serum levels of OC, ALP and PSA in the study group were significantly higher than those in the control group (all P <0.05). The levels of serum OC, ALP and PSA in grade Ⅱ were higher than those in level Ι and grade ¢ ó, ALP and PSA levels were higher than those in grade Ⅱ group (all P <0.05). The sensitivity, specificity and accuracy of combination of serum OC, ALP and PSA were 94.12%, 90.63% and 92.42 respectively %) Was significantly higher than that of OC (73.53%, 59.38%, 66.67%), ALP (67.65%, 59.38%, 63.64%) and PSA (70.59%, 56.25%, 63.64% P <0.05). Conclusions The combined detection of serum OC, ALP and PSA levels can effectively improve the specificity, accuracy and sensitivity of bone metastases detection in patients with prostate cancer, and may be of reference value in assessing the severity of bone metastases.